Anorexia or anorexia nervosa is a pathological eating disorder caused by mental disorders. Typical of anorexia is radical weight loss due to poor nutrition. In addition, those affected (mostly young girls in puberty) suffer from a disturbed self-perception and fear of becoming fat or even fat.
What is anorexia?
Anorexia nervosa is a pathological eating disorder, also known as anorexia nervosa in medical terminology. This disorder often affects young women and girls. Characteristic of anorexia nervosa is a severe loss of weight; in addition, affected patients usually have a panic fear of gaining weight again. If the body weight is more than 15 percent below normal weight, it is generally referred to as anorexia. Anorexia is a disease that must be taken seriously and is even fatal in about ten to 15 percent of cases. This is usually the case if the disease is not treated in time. Anorexia affects around 1.5 percent of women between the ages of 14 and 35. The proportion of those under 20 is enormously high; this disease usually develops during puberty. In principle, women are more often affected by this symptom, but in individual cases, men can also suffer from anorexia.
Causes
In most cases, family conflicts and problems trigger the anorexia disorder. Those who are psychologically unstable are more quickly afflicted by anorexia. In addition, genetic predisposition plays a major role. Although this has not yet been adequately researched, some people seem to be more susceptible to this disease than others. A disorder in the brain region responsible for eating behavior and the menstrual cycle can also be a cause of the disease anorexia. Of course, society also plays a very decisive role. Today’s ideal of beauty is primarily slim bodies; pubescent young people in particular are quick to throw themselves under this ideal. Girls who suffer from low self-esteem are much more likely to develop this disorder. In summary, therefore, it can be said that several factors usually interact to lead to the onset of anorexia.
Symptoms, complaints and signs
The most noticeable sign of anorexia is a severe weight loss that goes far beyond a healthy level. Even when significantly underweight, anorexics still perceive themselves as too fat – medical professionals refer to this as a body schema disorder. Objectively, anorexia can be considered to exist from a body mass index (BMI) of less than 17.5 m/kg², although in children and adolescents this threshold must be calculated in a more differentiated manner. If the weight loss progresses further, the body reduces both fat reserves and muscle mass. This stage of the disease is externally visible by strongly protruding bones, deep-set eyes and hollow cheeks, in many cases there is a clear physical weakness. In addition to weight loss, changes in eating behavior can also indicate anorexia. Affected individuals limit their meals to a minimum, avoid nutrient-rich foods, and count every calorie they eat. They often exercise excessively to reduce their weight, and some anorexics take laxatives or dehydration tablets to help them. Thinking revolves only around body weight; any slight increase in weight triggers dissatisfaction. Massive underweight impairs many bodily functions and can cause numerous complaints such as attacks of dizziness and weakness, constant freezing, constipation and cardiac arrhythmias. Difficulty concentrating, anxiety, mood swings, and social withdrawal associated with severe weight loss may also indicate anorexia.
Disease progression
Anorexia is accompanied by numerous symptoms. Clearly visible, of course, is weight loss; this can progress to the point where it can become life-threatening. Due to the inadequate diet, vital nutrients are naturally lacking. Another characteristic feature is the so-called body schema disorder. Affected patients generally consider themselves to be too fat and perceive their bodies differently than outsiders. The disease can be divided into two groups: about half of the patients are merely dieting, while the other 50 percent additionally show symptoms of bulimia.These patients eat a lot, but break this out again. Some patients also take laxatives to prevent weight gain. They also often engage in excessive sports. Anorexia naturally also causes hormonal changes in the body; menstruation is often absent. A desire to have children often remains unfulfilled for anorexics. Basically, the earlier anorexia is detected, the better the chances of recovery. The complications of anorexia nervosa are manifold and occur more frequently as the condition progresses. Up to 15 percent of all sufferers die as a result of their malnutrition – especially heart failure – or commit suicide.
Complications
Physical complications include any condition that occurs because of malnutrition. These include, for example, slowed heart activity that increases the risk of circulatory collapse, renal failure due to potassium and protein deficiency, and osteoporosis. The physical weakness, combined with a vulnerable circulatory system, can lead to falls that involve permanent fractures and adhesions due to weakened bones. Blood formation and composition is disturbed, which promotes further organ damage due to an undersupply of nutrients and oxygen. The weakened immune system provides increased susceptibility to infections that are usually easy to fight. Thus, even mild pneumonia or an intestinal infection can mean death. The decrease in brain mass leads to memory problems and coordination difficulties. This is only partially reversible. The poor psychological condition of many sufferers also manifests itself in self-injurious behavior. Even a treated and survived phase of anorexia usually leaves behind consequential damage, which means a lifelong increased risk of further illnesses for the affected person. Osteoporosis and renal insufficiency usually persist throughout life.
When should you see a doctor?
People whose body weight is too low according to BMI guidelines should see a doctor. If food intake is vehemently refused for several days or weeks or is very much reduced, a doctor is needed. If deficiency symptoms, hair loss or brittle nails occur, this indicates health impairments. If there is internal dryness, lassitude, or faintness, a doctor’s visit is needed. If girls or women do not have menstrual periods, a check-up visit to a doctor is necessary. If the life of the affected person is determined by food intake, weight and external appearance, medical help should be sought. If there is a rejection of one’s own body, a body schema disorder, or compulsive behavior, a physician should be consulted. If the person is no longer able to perform at work or school, if he or she withdraws from the social environment and if his or her strength is declining, a visit to the doctor is advisable. In the case of mental abnormalities, irritability and changes in personality, a doctor or therapist should be consulted. If food intake and excretions are closely documented and controlled, there is a problem that needs medical attention. Since anorexia can lead to a fatal course or trigger other serious complications, the timely assistance of a physician is necessary.
Treatment and therapy
In the disease of anorexia, it is primarily important to fight against the underweight, as this naturally affects all internal organs. Nutritional therapy measures should further help patients to fundamentally change their eating behavior and to learn to eat “properly” again. In addition, psychotherapeutic measures are necessary, since the patients’ attitude to food is of course fundamentally disturbed. Family therapies have also proven effective here, especially for young people. However, since those affected often refuse to take in food, it is not uncommon for this to be supplied via infusions. With the right therapeutic treatment and the willingness of the patient, there are good chances of curing anorexia. Important are the will, as well as the desire of the affected person to fight the disease. If there is uncertainty, or the desire to continue to maintain a very low body weight despite therapy, the chances of recovery worsen. A risk of relapse is thus more likely.
Aftercare
After therapy is complete, it makes sense to continue strengthening personal resources. Self-esteem often takes a key role in an eating disorder. Often, the disorder leads to social isolation. During aftercare at the latest, it is then time to rediscover old acquaintances and strengthen contact with friends and family members. In this context, people who until recently suffered from an eating disorder also have to deal with the question of how openly they want to deal with their medical history. Since eating disorders often develop in adolescence, many affected people first have to learn how to cope at school or in professional life again during aftercare. Even for adults, job applications or returning to the old job can be a challenge. Aftercare involves behavior in everyday life. This includes shopping, cooking and everyday household chores. Fixed structures can help maintain healthy behavior patterns that have been established. Psychological aftercare consists largely of relapse prevention. There may be other psychological problems in addition to the eating disorder that also need to be addressed.
Outlook and prognosis
In curing anorexia, it is also necessary to differentiate whether a complete cure should be sought or merely freedom from symptoms is sufficient. The latter is usually easier for patients to achieve because it allows certain behaviors to be maintained. In addition to psychological stabilization, physical recovery is also important. The longer the illness has already lasted and the more severe its course, the more likely it is that long-term consequences and irreversible damage will occur. For example, osteoporosis caused by anorexia, will persist even after a stable state has been reached. Basically, sufferers should be aware that the recovery period can last a long time, sometimes even several years. Without treatment, anorexia can become chronic and greatly complicate subsequent recovery. It also increases the risk of long-term consequences and acute symptoms, such as cardiac arrest. Overall, however, it can be said that a complete cure for anorexia is basically possible.
Here’s what you can do yourself
Anorexia is a very serious disease that can lead to death. It is imperative that the disorder be treated professionally. The victims themselves are usually only able to help themselves during the early stages or in less severe cases. In a severe course, the victims are usually unable or unwilling to recognize that they are ill and need help. Young girls and women are particularly often affected by the disease. Parents should therefore keep a critical eye on their children’s eating behavior. Not every attempt at dieting immediately represents a pathological disorder and must be treated. However, if children start to lose weight consistently, show no interest in eating or even invent excuses to avoid eating situations, countermeasures should be taken. Parents can then find help at counseling centers. Affected persons who are aware of their disorder and wish to be cured should definitely consult a doctor and a psychologist. In addition, there are also a few tricks that make the fight against the disease easier. Very often, the perceptual relationship is disturbed as far as food is concerned. Small portions are then perceived as huge. For this reason, food should always be served on very large plates to put this distortion into perspective. It is also often easier for sufferers to consume calories in liquid form. Green smoothies enriched with ground almonds or pine nuts are a healthy source of energy in these cases.